Healthcare Provider Details

I. General information

NPI: 1518242916
Provider Name (Legal Business Name): MICHELLE ELIZABETH DURRANT AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 BOARDMAN CANFIELD RD SUITE C1 WEST
BOARDMAN OH
44512-4300
US

IV. Provider business mailing address

755 BOARDMAN CANFIELD RD STE C1
BOARDMAN OH
44512-4387
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-8155
  • Fax: 330-726-8612
Mailing address:
  • Phone: 330-726-8155
  • Fax: 330-726-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA02008
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: